Documentary Response Piece: US Healthcare System Evaluation

This report provides a detailed analysis of the US healthcare system, comparing and contrasting it with the healthcare systems of the United Kingdom, Japan, Germany, Taiwan, and Switzerland. The analysis focuses on similarities, differences, strengths, and weaknesses of the US system, highlighting issues such as the lack of universal health insurance, high costs, and the impact of the Affordable Care Act (ACA). The report examines the ACA's goals, the expansion of Medicaid, the creation of health insurance marketplaces, and consumer protections. Additionally, it offers a response to the documentary, suggesting potential reforms, such as a system of universal health insurance, drawing on the examples of Japan and other nations with more effective systems. The report emphasizes the importance of policy in shaping healthcare outcomes and references supporting literature.

Running head: DOCUMENTARY RESPONSE PIECE 1
Documentary Response Piece
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Institutional Affiliation

DOCUMENTARY RESPONSE PIECE 2
DOCUMENTARY RESPONSE PIECE
PART A: Compare and Contrast
1. Similarities and Differences
Starting with the United Kingdom’s health system, it is extremely different from that of
the US. The United Kingdom has a medical system called the National Health System that is
operated via government taxes, hence each individual in the United Kingdom utilizes it and he or
she is never presented a bill at any time irrespective of the condition. Nonetheless, because the
United Kingdom has a free-market economic like the US, doctors remain presented with a “pay
for performance” system whereby competition stays extremely active and doctors shall be paid
more for better work done.
Like the United States, Japan has a huge economy and extremely promising health
statistics. Nonetheless, in Japan, each individual is required by law to purchase a health
insurance as opposed to the US. Due to this, individuals in Japan visit their doctors much more
as compared to Americans and remain the leaders globally in health statistics.
Germany which stays identical to the United Kingdom similarly goes through a National
Healthcare System. Characteristically, the rich always pay for the poor and the sick and are
covered by healthy essentially. German medical providers have to keep the rate at a desirable
standard change that maintains the prices down.
Taiwan has salient trouble making ends meet since they lack sufficient funds to keep their
healthcare system at its best. The government of Taiwan collected funds and, hence, pays the
healthcare providers. Thus, healthcare in Taiwan is left to the market. Each citizen in Taiwan has
“smart card” that entails her or his health info and the bills get paid via this card automatically.
Switzerland is identical to Taiwan, and has a system which never covers all of its people.
Switzerland has a national law called a LAMal which sets up a universal health system which

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limits insurance companies from realizing profits via basic health insurance. Like the United
States, the Swiss have a highly strong and powerful insurance program.
Essentially, Japan, UK, and Germany all remain very satisfied with their respective
medical programs throughout the country while Taiwan and Switzerland are unsatisfied.
However, Switzerland is better than Taiwan and remain more satisfied. Both UK and Japan
showcases very stronger healthcare systems.
2. Strengths and Weaknesses of the US Health System Compared
Some of the weaknesses in the United States healthcare system is the lack of universal
health insurance coverage for all citizens, highest expenses for the government as well as highest
costs for its patients unlike other nations. It remains a bazaar that the United States is spending
the most, yet it is ranked 37th globally in terms of best healthcare systems. Thus, while other
countries have ensured accessibility to care via universal health systems, and via better
relationship between patients and the healthcare provider practices which serve as their medical
homes, the US is not offering this making it a weakness. Whereas one of the strength of the US
healthcare system is that it remains one nation with best facilities in the globe than any of the
above mentioned countries to take good care of health of its citizens, it is unfortunate, however,
that not everyone has an opportunity to afford such a perfect system due to its too high prices
unlike in Japan, Germany, UK and Swiss. Solely individuals with health insurance in the US
have opportunity to go to hospital as insurance shall cover most of the bills. Indeed, the high cost
of healthcare in the US is making people go into bankruptcy and this is even sad because people
lose their insurance whenever they lose their jobs when essentially they need it the most. This
system is also weak because it is actually designed to allow insurance companies to make huge

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profits unlike other nations hence the insurance companies have the undesirable right to turn
down coverage to individuals with pre-existing conditions.
3. Changes through the Affordable Care Act
The Act dramatically altered the United States healthcare landscape. The main goals of
the Act was to lower the number of people not insured, make the coverage increasingly
affordable, as well as expand access to care (Andrews et al., 2018). To achieve these goals, the
Act expanded the Medicaid eligibility and established novel marketplaces whereby individuals
with no employer coverage might directly purchase policies from insurers.
The Medicaid program eligibility expansion to families and individuals with incomes
amounting to 138 percent of federal poverty line- nearly USD35, 000 for a family of 4. The
health insurance marketplaces were created at state level premised on choice and competition;
people could then compare identical coverage alternatives and select among rivaling plans.
Moreover, ACA provided low-income people and household with up to 400 percent of federal
poverty line accompanied by subsidies which helped buy insurance. This has seen more than
20M individuals being freshly insured, and nearly 24M others gaining accessing to subsidize or
free care via marketplace tax credits alongside Medicaid expansion.
The ACA significantly reshaped the US private insurance in significant ways. It created a
novel minimum federal consumer protections; remarkably, insurers stood barred from
discriminating based on health status-they could never henceforth turn individuals away or even
charge exorbitant premiums because of pre-existing medical conditions (Havrilesky, 2018). It
also defined a set of ten “essential health benefits and abolished lifetime and annual limits on
covered health benefits. The ACA’s dependent coverage provision allowed kids up to 26 years of

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age to remain on their parents’ insurance covers, which benefited between 2 to 3 million young
individuals.
Part B: Response
Anchored on the documentary and research, in my view, I think the United States health
system might be reformed in future considering the evolution of documentaries in documentary.
I think that the US might wish to consider either making all its citizens purchase health insurance
or surge taxes somewhat and subsequently have the government providing it to all its citizens at
no charge. Either of such alternatives remain extremely brilliant ideas. I think the US healthcare
system should go the Japanese healthcare system way since Japanese has the longest life
expectancy alongside lowest infant mortality. This will make the US to use social insurance
without making its people to pay for their insurance all through their taxes. This will make the
citizens to pay into social insurance fund to reduce cost to the government.
I think policy has an important role in health of a nation. It is the policy which determines
the kind of laws concerning health to be made to enhance the better healthcare provision to the
citizens. When the policies are bad, there would be bad laws and practices in place which hinder
better healthcare provision. The US healthcare policy has shaped the health of Americans. For
instance, the ACA has implemented comprehensive reforms which have improved the
accessibility, quality as well as affordability of healthcare. This policy has made remarkable
progress towards solving the US healthcare system long-standing challenges linked to access,
quality and affordability. Since this policy was enacted, the rate of uninsured has plunged by
43% from 16 percent in year 2010 to 9.1 percent in year 2015 due to its reforms (Barr, 2016).

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References
Andrews, C. M., Grogan, C. M., Smith, B. T., Abraham, A. J., Pollack, H. A., Humphreys, K., ...
& Friedmann, P. D. (2018). Medicaid benefits for addiction treatment expanded after
implementation of the Affordable Care Act. Health Affairs, 37(8), 1216-1222.
Barr, D. A. (2016). Introduction to US Health Policy: the organization, financing, and delivery
of health care in America. JHU Press.
Havrilesky, L. (2018). Measuring the Health Benefits of the Affordable Care Act for Young
Women. Obstetrics & Gynecology, 131(6), 964-965.